117CANADA.-NOTES FROM INDIA.

CANADA.

(FROM OUR OWN CORRESPONDENT.)

The Ontario Health Officers’ Association.THE fifth annual conference of the medical officers of

health of Ontario was held in Toronto this year, Dr. A. J.

Macaulay, of Peter borough, discharging the presidentialduties, and Dr. John W. S. McCullough, chief health officerfor Ontario, acting as secretary. Many interesting com-

munications were read bearing on the public health of theprovince.

Dr. M. B. Whyte, superintendent of the Isolation Hos-pital, Toronto, read a paper on the Quarantine Periodfor Measles, a disease which has been widely prevalent inOntario the past six months, and from the discussion whichfollowed the consensus of opinion of 400 health officers wasthat 16 days’ exclusion from school following exposure wasneedless. It was agreed that those who suffer from thedisease should be quarantined for seven days after the rashappears unless there are discharges or epistaxis, and that assecond attacks are rare, those who have previously had thedisease need not be quarantined at all.

Dr. Fred. Adams, epidemiologist to the Toronto Board ofHealth, gave a resume of his observations upon typhoid feverin Toronto in the last six years, showing a remarkableimprovement in the condition. In 1910 the death-rate fromtyphoid fever was 40 per 100,000 ; five years later, in 1915,it was only 1. 9, the lowest rate of any of the large cities inAmerica. The chief factors in this reduction Dr. Adamsascribed to chlorination of the water-supply, pasteurisationof milk, certified milk, and a campaign against flies andoutdoor privies.

Dr. J. G. Fitzgerald, of the Ontario Department of Health,read a paper on the Epidemic of Cerebro-spinal Meningitiswhich occurred among troops quartered in Toronto, andreported that ’’ all the cases among troops in the TorontoMilitary District have recovered."Among other interesting communications may be men-

tioned that of Dr. W. H. Park, Director of the Public HealthLaboratories, New York City, who, speaking on the treat-ment of diphtheria, advised the use of antitoxin in largedoses, adding that the intravenous use of antitoxin was moreeffective than either the intramuscular or subcutaneous. Insevere cases he gave, he said, from 5000 to 15,000 units toa child, with correspondingly large doses in the ’adult.

Laryngeal cases require early and large doses.Major W. D. Sharpe (Brampton), who served as surgeon in

the British Naval Hospital at Belgrade in the first year ofthe war, gave an interesting lecture on Sanitation in Serbia ;and Captain Ruggles George, A.M.C. (Toronto), told the

interesting story of the first Canadian Overseas Contingent,taking the contingent from Camp Valcariter in Quebec tothe trenches in Flanders.

Ontario Medical Association.The thirty-sixth annual conference of the Ontario Medical

Association was held in Toronto at the beginning of June,Dr. Harry B. Anderson (Toronto) presiding. Over 450medical practitioners from all parts of the province attended.Dr. Anderson, in his presidential address, discussed the im-portant question of medical education in the province. He

thought that there should be a strict uniform examinationfor the practice of medicine, and no granting of specialprivileges to those’ not fully trained and unequal to meet therequirements of the medical examination. He consideredthat from the standpoint of the medical profession the newOntario Workmen’s Compensation Act was most unsatis-factory in some particulars, notably the absence of a clauseproviding for the prompt and proper payment of the medicalman for his services. Under this Act physicians in Ontarioare practically compelled to attend injured workmen with-out pay. In dealing with the general organisation work ofthe profession in the province, the President stated thatthere were now some 35 local medical societies in theprovince ready to affiliate with the Ontario Medical Associa-tion. He alluded also to the large number of Canadianpractitioners engaged in the war. Professor A. D.Blackader (Montreal) said that after the war Canadianphysicians should favour the home-made or British-made drugs, as certain lines of drugs already made inCanada since the outbreak of the war had been entirely

satisfactory. At the conclusion of this paper the Presidentstated that he had a communication from the FederalGovernment to the effect that it purposes revising the PatentMedicines Act, and advising the association to make repre-sentations to the Government. A committee was appointedto take care of this matter. The therapeutics of pneumoniawas discussed by Professor Solomon Solis Cohen, of Phil-adelphia, U.S.A., and Dr. Elliott P. Joslin, of Boston, read apaper on the treatment of diabetes, recommending the

cutting down of carbonaceous foods and the exclusion offats until the patient was got into a state of moderate fasting.Dr. John A. Wyeth, Dr. John A. Bodine, and Dr. C. H.Chetwood, of New York, explained the use of the movingpicture in showing surgical technique. The demonstrationsincluded hip-joint operations and kidney removals, andformed one of the features of the meeting. The followingofficers were elected :-President : Dr. A. Dalton Smith,Mitchell ; Vice-President : Dr. Clarence Starr, Toronto;General Secretary : Dr. F. Arnold Clarkson, Toronto.Toronto, June 24th.

__

NOTES FROM INDIA.

(FROM OUR OWN CORRESPONDENTS.)

Malaria Committees Abolished in the United Provinces.THE United Provinces Government has decided to abolish

the provincial and divisional malaria committees whichcame into existence in the summer of 1910. A Governmentresolution explaining the reasons for this step says : "Someuseful work has been done by provincial committees, butexperience has shown that their duties, which have con-sisted in collecting information and suggesting remediesfor disease, overlap with those of the Sanitary Board. Theseduties will be transferred to the Sanitary Board, of whichthe Inspector-General of Civil Hospitals will now become amember. The duties assigned to divisional malaria com-mittees were of a similar nature to those of provincialcommittees. The divisional committees have proved to beinadequately equipped for their duties. Malarial survey is acondition precedent to the initiation and elaboration of anti-malaria measures, but it requires for its execution theservice of experts, and divisional committees have not andcannot well have at their disposal any expert agency. The

surveys that have been made at Saharanpur, Kosi, Nagina,and Lucknow have been the work of officers of the SanitaryDepartment, and all future surveys will be similarly initiatedand controlled. In several divisions committees have alreadyceased to meet, and in the remaining divisions the resultsachieved are not such as to justify their further retention.

The Bombay Medical Union.At the annual meeting of the Bombay Medical Union Dr.

H. S. Shroff, the President, delivered an address of widepolitical scope. Alluding to the enlistment of members ofthe independent medical profession " by Government at thelocal war hospitals, at base hospitals, and at several

spheres of the war, he said that in the representation bythe Bombay Medical Union to the Royal Public ServicesCommission it was stated that the cadre of the IndianMedical Service on the civil side could be reduced and couldbe replaced by civilian practitioners after competitive exa-mination. It was in this way proposed that a civil medicaldepartment, when created, should form a reserve for the

army in time of war ; and since the outbreak of war 166temporary commissions have been issued, out of which 32appointments of lieutenants in the Indian Medical Servicewere made in England and 134 in India.With reference to the Bill to prevent the grant to un-

qualified persons of titles implying qualifications in Westernmedical science and the assumption and use by such personsof such titles or designations implying such qualifications, he said that the measure had been brought before theCouncil by "that sympathetic and statesmanlike member ofthe Council, the Director-General of the Indian MedicalService, who has been the custodian of the interests of thatservice and other services and keen to safeguard theirinterests, and who is also keen to advance the status and

aspirations of the Indian medical profession."The third subject to which the speaker referred as one to

which the Union had been giving special attention was the

1 THE LANCET, May 13th, 1916, p. 1011.

118 ASYLUM REPORTS.

foundation of a new college in Bombay. The trustees of thelate Seth Gordhandan Sunderdass Charities have offered tothe corporation the princely donation of Rs. 12 lakhs fromtheir funds for founding a medical college in Bombay.The corporation has taken an enlightened view of the

proposal and has asked their Medical Relief Committee toreport on its practicability. " The Bombay Medical Union, ’said their President, ’’ is delighted with the offer, consideringit to be conceived in the interests of medical science bythe indigenous qualified profession. The present system ofmedical education in India was conceived in 1845, whennot a single Indian was possessed of Western medical educa-tion and qualification. Naturally, officers of the IndianMedical Service in the employ of the Government were putin charge of teaching colleges like the Grant Medical Collegeon our side. To those pioneers of medical education we owea deep debt of gratitude for their unselfish efforts in the Icause of medical education. But the pupils of the college, ’,owing to the system of the covenants on which the European

’’

teachers were engaged when coming out to India, could notbecome teachers in their own college, though certain appoint-ments have been made in the junior subject of botany."Dr. Shroff added that recently under the stress of war, threeappointments from among the Indian medical profession hadbeen made to professorial chairs.

shortage of Medical Men.The Government of India have had under consideration

- the question of offering enhanced terms to civil sub-assistantsurgeons on military duty, including those already employed,who undertake liability for field service out of India and on- expeditions based on the frontiers of India during the presentemergency. They have now decided that each civil sub-assistant surgeon on signing the declaration, undertakingthe liability to proceed on active service when ordered, willreceive his civil pay, plus military pay, plus compensationfor loss of private practice, plus an outfit allowance, free’rations, and the usual service concessions for families. Theseliberal terms ought to draw a very large number of thesemen from civil to military employ, more especially as inaddition to the above each sub-assistant surgeon will receive

,permanent promotion without departmental examination to- the next higher grade, should such promotion become duewhilst in military employment, provided that he has a

good record of service generally and has been reported onby the military authorities as fit for promotion. Further,it has been specially provided that the civil prospects ofsuch civil sub-assistant surgeons as volunteer for fieldservice shall not be adversely affected. The fact of

undertaking liability for field service will, on the contrary,be taken into account as conferring a special claim to con-sideration hereafter should prospects of promotion offer forwhich the sub-assistant surgeon is otherwise fit.

Plzntaan Juice as an Antidote for Snake-bite.I recorded recently a case of alleged cure of snake-bite at

Colombo by the use of plantain juice.2 A case of snake-bite at Serampore will therefore be of interest where

- plantain juice was used. A servant of the principalof the Government Weaving College was bitten by a

venomous snake in the foot. The principal applied a

- ligature eight inches above the bitten part and then cut itwith a lancet and applied permanganate of potash, makingthe wound bleed freely. He then extracted some juice from.a plantain tree and gave the patient about a cupful to drink.After drinking the plantain juice, the man seemed to recovera little, and the wound was washed. He was made to walk

up and down, and in the morning, when the ligature wasremoved, the man was declared cured.June 10th.

2 THE LANCET, April 1st, 1916, p. 746.

THE RESEARCH DEFENCE SOCIETY.-The annual.general meeting of this society has been postponed owing tothe war, many of its members being engaged on activeservice, while others have their time fully occupied invarious kinds of work on behalf of the sick and wounded inthis country. But the propaganda work of the society isstill actively carried on under the direction of Mr. StephenPaget. Among the most recent literature issued by thesociety are reprints from the Field and English Lllechaitic,bringing before the public in clear language the value ofscientific pathological work both to our Army and to the.civilian population.

ASYLUM REPORTS.

Kingseat Mental Hospital (Aberdeen City District Board ofControl) (Annual Report tor the Year 1915).-The totalnumber of cases under treatment during the year was 665,the average daily number resident being 527. The numberof admissions amounted to 171, of which 49 were transferredfrom other asylums. Of those admitted 2 were not insane,44 were curable, 107 were absolutely incurable, and in 18 theprospect of recovery was doubtful. The most prevalentforms of disease were those embraced under the term manic-depressive insanity, imbecility and idiocy, the alcoholicpsychoses, primary dementia of adolescence, epilepticinsanity, and arterio-pathic and senile dementia. With

regard to the duration of illness prior to admission,it was found that of the direct admissions 93 hadbeen mentally ill for less than three months, 8 for less than12 months, and the remainder for over 12 months. Hereditarypredisposition was present in 33 cases, and 18 had sufferedfrom one or more previous attacks. The discharges duringthe year numbered 75, the percentage of recoveries on theadmissions being 32 1, which was 4 per cent. lower than in theprevious year. This decrease was due to the admission of 40incurable patients from Edinburgh and Glasgow respectively.Excluding these extraneous admissions, the percentage ofrecoveries among the Aberdeen admissions was 40-4, being4 per cent. higher than in 1914. There were 50 deaths-29 men and 21 women ; of these, 12 were over 70 years ofage. The war has had so far practically no material effecton the admission rate.

Maddlesbrozogh County Borough lI-Iental Hospital (AotzazcalReportfor the Year 1915).-The total number of cases undertreatment during the year was 639, with an average dailynumber resident of 472. The admissions, which totalled207, included 116 cases transferred from Newcastle CityAsylum in April. There were 79 from the borough, a

decrease of 5 as compared with the previous year, but thenumber resident was increased by 9. The proportion of theinsane to the estimated population of the borough was 1 to 402,or 24’ 8 per 10,000, the figures for England and Wales being1 to 266, or 37-6 per 10,000. The total number of discharges,96, included 54 patients transferred to Chester Asylum. Therecoveries were 30, making a recovery rate of 37 on thedirect admissions. The report states that one of the patientswho escaped was a man who had been in the asylum sinceshortly after it was opened in 1898. He was ordinarilywell-behaved and was allowed a good deal of liberty,but he had a habit of talking to himself and cursingimaginary enemies while at work. One morning he did notreturn to breakfast, and when next heard of he was with theRoyal Engineers in Flanders. The deaths numbered 58,making a rate of 12’2 on the average daily number resident.Post-mortem examination was made in 41 cases. Therewere 17 private patients on the register at the end of theyear, 4 having been admitted, 1 discharged recovered, and6 having died during the year.

Cozc.nty and City of jY’oreester Lunatic Asyl1f?n, Powick(Ann1fal Report for the Year 1915).-The total number ofcases under treatment during the year was 1531, the averagedaily number resident being 1262. There were 405 admis-sions, of which 144 were direct, the remainder being trans-ferred from other asylums. The discharges numbered 83,of which 59 were recovered, making a recovery rate of40 95 per cent. on the direct admissions. One patient wasdischarged "not insane." A male patient was prosecutedfor a murderous assault on the son of the medicalsuperintendent. He was found "Guilty, but insane."He was removed to a criminal asylum. An interestingmedico-legal feature was that the man appealed againstthe verdict. The Court of Appeal held that the verdict"Guilty, but insane " was not a conviction, and thata man who was not convicted could not appeal. There were99 deaths, making a death-rate of 7-9 per cent. on the dailyaverage number resident. The principal causes of deathwere as follows : Pulmonary tuberculosis, 21 ; heart disease,20 ; senile decay, 17 ; epilepsy, 8 ; and pneumonia, 6. Post-mortem examinations were held in 89 cases, a percentage of89’8. On Jan. lst, 1915, there were 24 private patients inresidence. Four females were discharged. One male andtwo females died. On Dec. 31st, 1915, there were 19remaining.